Barbed sutures and connecting devices have been historically described and used in flexor tendon tenorrhaphies. With the improvement in biomaterial, we have witnessed recently the resurgence of this concept. In this article, we review the historical use of barbed devices in repairing flexor tendons and explore the available barbed surgical devices that have been described in recent years.
AllieuY. 1977 Note De Catamnese—L'utilisation du Barb-Wire de Jenning en chirurgie de la main. Ann Chir.1977;31:359–61.
3.
BunnellS. Gig pull-out suture for tendons. J Bone Joint Surg Am.1954;36-A(4):850–1.
4.
CannonNMStricklandJW. Therapy following flexor tendon surgery. Hand Clin.1985;1:147–65.
5.
CooneyWPWeidmanKMaloD. Management of acute flexor tendon injury in the hand. Instr Course Lect.1985;34:373–81.
6.
ElhassanBMoranSLBravoC. Factors that influence the outcome of zone I and zone II flexor tendon repairs in children. J Hand Surg Am.2006;31(10):1661–6.
7.
HagbergLSelvikG. Tendon excursion and dehiscence during early controlled mobilization after flexor tendon repair in zone II: an x-ray stereophotogrammetric analysis. J Hand Surg Am.1991;16(4):669–80.
8.
HirparaKMSullivanPJO'SullivanME. A new barbed device for repair of flexor tendons. J Bone Joint Surg Br.2010;92 (8):1165–70.
9.
IngleNPKingMW. Optimizing the tissue anchoring performance of barbed sutures in skin and tendon tissues. J Biomech.2010;43 (2):302–9.
10.
IngleNPKingMWZikryMA. Finite element analysis of barbed sutures in skin and tendon tissues. J Biomech.2010;43(5):879–86.
11.
JenningsER. Tendon sutures. Md State Med J.1954;3(1):17–8.
12.
JenningsERMansbergerARJrSmithEP. A new technique in primary tendon repair. Surg Gynecol Obstet.1952;95(5):597–600.
13.
JenningsERYeagerGH. Barbwire tendon suture; clinical experience with thirty flexor tendons. AMA Arch Surg.1955;70 (4):566–9.
14.
KhannaAGougouliasNMaffulliN. Modalities in prevention of flexor tendon adhesion in the hand: what have we achieved so far? Acta Orthop Belg.2009;75(4):433–44.
15.
KimPTAokiMTokitaF. Tensile strength of cross-stitch epitenon suture. J Hand Surg.1996;21(6):821–3.
16.
LengemannF. A new wire tendon suture. Zentrabl Chir.1951;76 (14):964–7.
17.
Marin BraunFFoucherGBuch JaegerN. Repair of the flexor digitorum profundus and the flexor pollicis longus by the “rope down” technique. Results in a series of 77 cases. Ann Chir Main Memb Super.1991;10(1):13–21.
18.
MckeeGK. Metal anastomosis tubes in tendon suture. Lancet.1945;245(6352):659–60.
19.
McKenzieAR. An experimental multiple barbed suture for the long flexor tendons of the palm and fingers. Preliminary report. J Bone Joint Surg Br.1967;49(3):440–7.
20.
McKenzieAR. Function after reconstruction of severed long flexor tendons of the hand. A review of 297 tendons. J Bone Joint Surg Br.1967;49(3):424–39.
21.
MomoseTAmadioPCZhaoCZobitzME. The effect of knot location, suture material, and suture size on the gliding resistance of flexor tendons. J Biomed Mater Res.2000;53 (6):806–11.
22.
MomoseTAmadioPCZhaoC. Suture techniques with high breaking strength and low gliding resistance: experiments in the dog flexor digitorum profundus tendon. Acta Orthop Scand.2001;72(6):635–41.
23.
MoriyaTZhaoCAnKN. The effect of epitendinous suture technique on gliding resistance during cyclic motion after flexor tendon repair: a cadaveric study. J Hand Surg.2010;35(4):552–8.
24.
MoriyaTZhaoCYamashitaT. Effect of core suture technique and type on the gliding resistance during cyclic motion following flexor tendon repair: a cadaveric study. J Orthop Res.2010;28(11):1475–81 (Research support, Non-US Government).
25.
MorizakiYZhaoCAnKN. The effects of platelet-rich plasma on bone marrow stromal cell transplants for tendon healing in vitro. J Hand Surg.2010;35(11):1833–41.
26.
ParikhPMDavisonSPHigginsJP. Barbed suture tenorrhaphy: an ex vivo biomechanical analysis. Plast Reconstr Surg.2009;124 (5):1551–8.
27.
RezvaniH. Use of “Barb-wire” for repair of flexor tendons of the fingers. Apropos of 18 cases. Bull Mem Soc Chir Paris.1974;63 (2):107–13.
28.
RocchiLMerolliAGenziniA. Flexor tendon injuries of the hand treated with TenoFix: mid-term results. J Orthop Traumatol.2008;9(4):201–8.
29.
ShawPC. A method of flexor tendon suture. J Bone Joint Surg Br.1968;50(3):578–87.
30.
StricklandJW. Flexor tendon repair. Hand Clin.1985;1(1):55–68.
31.
StricklandJW. Results of flexor tendon surgery in zone II. Hand Clin.1985;1(1):167–79.
32.
StricklandJW. Flexor tendon injuries: II. Operative technique. J Am Acad Orthop Surg.1995;3(1):55–62.
33.
StricklandJW. Development of flexor tendon surgery: twenty-five years of progress. J Hand Surg.2000;25(2):214–35.
34.
StricklandJW. The scientific basis for advances in flexor tendon surgery. J Hand Ther.2005;18(2):94–110. quiz 111.
35.
SuBWProtopsaltisTSKoffMF. The biomechanical analysis of a tendon fixation device for flexor tendon repair. J Hand Surg.2005;30(2):237–45.
36.
SuBWSolomonsMBarrowA. Device for zone-II flexor tendon repair. A multicenter, randomized, blinded, clinical trial. J Bone Joint Surg Am.2005;87(5):923–35.
37.
ThurmanRTTrumbleTEHanelDP. Two-, four-, and six-strand zone II flexor tendon repairs: an in situ biomechanical comparison using a cadaver model. J Hand Surg.1998;23(2):261–5.
38.
TrocchiaAMAhoHNSobolG. A re-exploration of the use of barbed sutures in flexor tendon repairs. Orthopedics.2009;32 (10):731.
39.
WintersSCGelbermanRHWooSL. The effects of multiple-strand suture methods on the strength and excursion of repaired intrasynovial flexor tendons: a biomechanical study in dogs. J Hand Surg.1998;23(1):97–104.
40.
WolfeSWWillisAACampbellD. Biomechanic comparison of the Teno Fix tendon repair device with the cruciate and modified Kessler techniques. J Hand Surg.2007;32 (3):356–66.
41.
ZhaoCAmadioPCMomoseT. The effect of suture technique on adhesion formation after flexor tendon repair for partial lacerations in a canine model. J Trauma.2001;51 (5):917–21.
42.
ZhaoCAmadioPCZobitzME. Gliding characteristics of tendon repair in canine flexor digitorum profundus tendons. J Orthop Res.2001;19(4):580–6.
43.
ZhaoCAmadioPCZobitzME. Gliding resistance after repair of partially lacerated human flexor digitorum profundus tendon in vitro. Clin Biomech.2001;16(8):696–701.
44.
ZhaoCSunYLIkedaJ. Improvement of flexor tendon reconstruction with carbodiimide-derivatized hyaluronic acid and gelatin-modified intrasynovial allografts: study of a primary repair failure model. J Bone Joint Surg Am.2010;92 (17):2817–28.
45.
ZhaoCZobitzMESunYL. Surface treatment with 5-fluorouracil after flexor tendon repair in a canine in vivo model. J Bone Joint Surg Am.2009;91(11):2673–82.
46.
ZobitzMEZhaoCAmadioPC. Comparison of mechanical properties of various suture repair techniques in a partially lacerated tendon. J Biomech Eng.2000;122(6):604–7.